ArticleSurgical endoscopy2026
Investigating the utility of EndoFLIP™ as a screening tool for pathologic reflux EndoFLIP™ as a screening tool for GERD.
Article in Surgical endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe Endoluminal Functional Lumen Imaging Probe (EndoFLIP™) is increasingly utilized in the diagnostic evaluation of gastroesophageal reflux disease (GERD). At our Center, EndoFLIP™ is routinely performed before Bravo™ pH monitoring during preoperative esophagogastroduodenoscopy to exclude major motility disorders in patients being considered for antireflux surgery. According to Lyon Consensus 2.0, the presence of Los Angeles (LA) grade B or higher esophagitis is diagnostic for GERD, obviating the need for pH testing. In select cases, bypassing pH monitoring reduces costs, improves workflow efficiency, and expedites symptom management. This study aimed to evaluate whether EndoFLIP™ measurements independently predict Bravo™ pH positivity and to assess the diagnostic accuracy of distensibility index (DI) thresholds.
methodsWe conducted a single-center retrospective review of adults with native anatomy who underwent 96-h Bravo™ pH monitoring and concomitant EndoFLIP™ at index EGD between October 2022 and August 2024. Patients with positive (Bravo +) and negative (Bravo-) studies were compared. Diagnostic accuracy of DI values (DI50, DI60, DI70) was assessed using receiver operating characteristic (ROC) curves, with area under the curve (AUC) and 95% confidence intervals (CI).
resultsA total of 171 patients were included (64 Bravo + , 107 Bravo-). LA grade B esophagitis was more common among Bravo + patients (7.8% vs. 0%, p = 0.007). Median DI60 was significantly higher in Bravo + patients (4.0 vs. 3.4 mm
conclusionDI60 values are significantly associated with Bravo + testing. Across the overall cohort and male sex, DI50 and DI60 demonstrated a strong diagnostic performance, while DI70 showed better performance in females.
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